Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 1998
Randomized Controlled Trial Clinical TrialClonidine does not attenuate median nerve somatosensory evoked potentials during isoflurane anesthesia.
Clonidine, an alpha2 agonist, reduces the requirements of several anesthetics. However, the effects of clonidine on somatosensory evoked potentials (SEPs) are unclear. These effects on cortical SEPs during isoflurane anesthesia were studied in 20 ASA I-II patients scheduled for elective surgery. Furthermore, the isoflurane concentration required to induce electroencephalogram (EEG) burst-suppression with and without clonidine was studied. METHODS. Anesthesia was maintained with isoflurane at a FiO2 of 0.4. At 1 MAC isoflurane the patients were randomly given either intravenous clonidine 2 microg kg(-1) (ten patients) or saline (ten patients). Finally, the isoflurane concentration was increased to a point at which a burst-suppression pattern appeared in the EEG. SEPs upon median nerve stimulation were recorded (1) before induction of anesthesia, (2) at 1 MAC before clonidine/saline, (3) at 1 MAC after clonidine/saline, (4) at EEG burst-suppression. ⋯ The effect of clonidine in reducing the requirements of anesthetics during general anesthesia is not seen in the cortical SEPs. The isoflurane-induced burst-suppression in the EEG was not affected by clonidine, suggesting that the EEG effects of clonidine and isoflurane were not additive. If SEPs are monitored intraoperatively, clonidine can be used as an adjuvant during isoflurane anesthesia without harmful effects on SEP monitoring.
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J Clin Monit Comput · Apr 1998
Influence of pulse oximeter settings on the frequency of alarms and detection of hypoxemia: Theoretical effects of artifact rejection, alarm delay, averaging, median filtering or a lower setting of the alarm limit.
The potential benefit of a reduced frequency of false pulse oximeter low oxyhemoglobin saturation (SpO2) alarms is that the attention of personnel is only directed to patients who experience hypoxemia. The present study was undertaken to better understand the effects of different settings of the pulse oximeter on false (artifact) and true (hypoxemia) alarms. ⋯ The data from the present study suggest that in order to effectively suppress false alarms caused by pulse oximeter artifacts, it may be preferable to use a longer filtering epoch of approximately 40 s, rather than to decrease the lower alarm limit.